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Pharmacokinetic Considerations of Oral Chemotherapy in Elderly Patients with Cancer

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Abstract

Persons over the age of 65 years are the fastest growing segment of the US population. In the next 30 years they will comprise over 20% of the population. Fifty per cent of all cancers occur in this age group and therefore there will be an expected rise in the total cancer burden. There has been an increasing trend over the past 20 years toward the use of oral chemotherapy. This change has been encouraged by the need to decrease the costs of chemotherapy administration, patient preferences and quality of life issues. Factors that must be considered with oral chemotherapy administration include limitations of saturability of absorption, patient compliance and pharmacokinetic/pharmacodynamic changes which occur in elderly patients. Interpatient variability and drug metabolism, particularly age-related changes in drug metabolism are being studied. The cytochrome P450 system has been intensively studied because of its importance with regard to chemotherapeutic drugs. This article reviews these issues and provides details regarding specific drugs including temozolomide, thalidomide, topotecan, the fluoropyrimidines, etoposide, hydroxycarbamide (hydroxyurea), tamoxifen, and alkylating drugs. Complementary and alternative therapies are also discussed.

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There were no sources of funding used to assist in the preparation of this manuscript. The authors have no current or potential conflicts of interest that are directly relevant to the contents of this manuscript.

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Authors and Affiliations

  1. College of Pharmacy and Allied Health Professions, St. Johns University, Jamaica, New York, USA

    J. Andrew Skirvin

  2. Don Monti Division of Medical Oncology, North Shore University Hospital-New York University School of Medicine, 300 Community Drive, Manhasset, New York, 11030, USA

    J. Andrew Skirvin & Stuart M. Lichtman

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  1. J. Andrew Skirvin
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  2. Stuart M. Lichtman
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Correspondence to Stuart M. Lichtman.

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Skirvin, J.A., Lichtman, S.M. Pharmacokinetic Considerations of Oral Chemotherapy in Elderly Patients with Cancer. Drugs Aging 19, 25–42 (2002). https://doi.org/10.2165/00002512-200219010-00003

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